Provider Demographics
NPI:1396740148
Name:FIEDLER-EATON, RUTH M (APN)
Entity type:Individual
Prefix:
First Name:RUTH
Middle Name:M
Last Name:FIEDLER-EATON
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:RUTH
Other - Middle Name:M
Other - Last Name:FIEDLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:865 LINCOLN RD
Mailing Address - Street 2:STE L10
Mailing Address - City:BETTENDORF
Mailing Address - State:IA
Mailing Address - Zip Code:52722-4159
Mailing Address - Country:US
Mailing Address - Phone:563-355-9191
Mailing Address - Fax:563-355-3419
Practice Address - Street 1:530 12TH ST
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:IL
Practice Address - Zip Code:61250-9461
Practice Address - Country:US
Practice Address - Phone:309-659-2215
Practice Address - Fax:309-659-2006
Is Sole Proprietor?:No
Enumeration Date:2005-06-17
Last Update Date:2023-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209-000647363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
049734OtherHEALTH ALLIANCE
IL0129OtherJOHN DEERE HEALTH PLAN
149294OtherIOWA HEALTH SOLUTIONS
4796890014OtherDMERC
049734OtherHEALTH ALLIANCE
S90267Medicare UPIN